Anemia or anaemia (/əˈniːmiə/; also spelled anæmia) is usually defined as a decrease in the amount of red blood cells (RBCs) or hemoglobin in the blood. It can also be defined as a lowered ability of the blood to carry oxygen. When anemia comes on slowly the symptoms are often vague and may include: feeling tired, weakness, shortness of breath or a poor ability to exercise.